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Ontario’s two opposition parties are demanding more transparency and accountability from the organization that acts like a legal insurer to doctors.

“This all looks very bad from beginning to end. Things have to change,” NDP health critic France Gelinas said Tuesday, commenting on a Star investigation into the Canadian Medical Protective Association.

Doctors who are accused of medical negligence, criminal offences or regulatory transgressions get assistance from the deep-pocketed CMPA, a self-described “mutual protection” association. It gets most of its funding from taxpayers, via doctors, and has a reputation for aggressively defending its clients.

Gelinas said she doesn’t agree with the CMPA’s view that it is not publicly funded since its revenue does not come directly from taxpayers. The money comes from physicians who are then reimbursed by the province, she noted.

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“I don’t care that the money funnels through doctors. At the end of the day it’s taxpayers’ money, and the CMPA must be publicly accountable for how it uses it,” she charged.

Taxpayers last year forked out almost $200 million to subsidize physician’s annual CMPA fees, an amount that has grown by 3,200 per cent in 28 years. Ontarians now pay 81 per cent of physician fees, and doctors pay the rest.

“There is no way hundreds of millions of dollars of taxpayers’ money should be going to an agency for which we have no accountability and no transparency. This is unacceptable,” Gelinas argued.

She wants the CMPA to be included under a private member’s bill she introduced earlier this year that would expand government oversight of the health sector. If passed, the bill would allow the provincial auditor and ombudsman to investigate the CMPA and make it subject to freedom-of-information legislation, as far as its dealings with Ontario doctors go.

Conservative associate health critic Bill Walker also wants more accountability from the CMPA. He takes issue with taxpayer dollars being used to defend doctors in criminal cases.

“We want transparency so taxpayers know where their money is going. How many cases are being funded, and how many dollars are being spend on each doctor?” Walker asked.

The public is entitled to know if a small groups of doctors continuously runs into trouble and racks up big bills, he said, hastily adding that it’s also important to protect doctors from frivolous lawsuits.

“If the doctor is a sexual predator, I don’t think taxpayers’ money should be spent here,” he said.

Even the government has big problems with the CMPA, said a source close to government. The issue of steeply rising CMPA subsidies was a sore point for government during last year’s contract talks with the Ontario Medical Association, which represents Ontario 28,000 doctors.

The CMPA subsidies became part of the negotiations in 1987, when the government agreed to pay a portion of physician fees in lieu of increasing their compensation.

The source said the government is looking at alternative ways of funding doctors’ legal liability protection because it can’t keep up with the CMPA fee increases.

Dr. Douglas Bell, the CMPA’s associate executive director, said the organization is publicly accountable to the extent that it makes financial statements available on its website.

He said that if the government wanted to change what kind of CMPA protection it provides reimbursement for, for example legal assistance for criminal charges, that could be discussed during OMA talks.

Bell took issue, however, with an assertion made in the Star investigation by Halifax lawyer John McKiggan, who said patients often don’t pursue malpractice lawsuits because they are unaware they are victims of medical errors. Bell said doctors are obliged to tell patients if mistakes were made.

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